Q: Why is Barton expanding?
Barton Memorial Hospital in South Lake Tahoe has aging infrastructure and will no longer meet California’s seismic safety regulations taking effect by 2030. The expansion will allow for updates to aging infrastructure while providing state-of-the-art technology and facilities at each campus location to meet the future of healthcare in our community.
In addition, healthcare has undergone dramatic changes in the past decade. Fewer people receive care in hospitals. Reimbursements from federal and state-subsidized insurance programs such as Medi-Cal do not come close to covering the rising costs of delivering care. This growing gap, along with California’s burdensome regulatory requirements, is forcing California hospitals to adapt their business model and in many cases, even close less-profitable yet needed services in order to remain viable. Currently, more than 70% of California hospitals have unsustainable business models including Barton.
As most care today is delivered in outpatient settings, like a doctor’s office, at a surgery center, or in a walk-in or urgent care clinic, the regional expansion will meet these needs through a dual-campus strategy: offering outpatient services at both the Stateline and South Lake Tahoe campuses, while building a new state-of-the art inpatient hospital in Nevada.
Q: Why Nevada?
After nearly a year of analysis, consideration and input, Barton’s board of directors voted to develop in-depth plans for building a new hospital in Nevada, which, when completed, will replace our current acute care facility (inpatient hospital) in South Lake Tahoe.
Barton is a bistate health system with campuses in both South Lake Tahoe and Stateline, as well as medical offices and a joint ownership of Carson Valley Health across Northern Nevada. This experience has illustrated the favorable and sustainable business model for Nevada health systems, allowing for continued breadth of services in our region.
Additionally, the current campus in South Lake Tahoe is at maximum space capacity, meaning there is neither available land nor development capabilities for new hospital construction to meet the growing needs of the community as well as California’s regulatory requirements, without removing the old hospital first.
The advantages of constructing a new hospital in Nevada include:
- Hospital services will remain open throughout the building process resulting in less patient disruption and operational downtime throughout the health system
- Quicker completion time in Nevada vs California
- Significantly lower costs means more facilities/services are possible to serve patients/community
- Future growth opportunities in Nevada allowing for additional facilities to be added over time
Q: Is Barton completely leaving South Lake Tahoe?
As the primary community health partner in Lake Tahoe, Barton intends to maintain a robust presence within South Lake Tahoe.
The dual-campus strategy will include expansion of the current Barton Community Health Center, to meet the growing health needs of patients insured through state-based programs. Plans also include outpatient primary care and specialty offices remaining on the South Lake Tahoe campus. Additional services are being assessed and a comprehensive plan is in development.
Q: How will this affect patients?
Changes to Barton’s campuses will take years to complete. In the short term, patients will have access to the same services currently offered. Any transitions, such as office relocations, will be planned with an emphasis on minimizing patient impact.
In the long term, patients will experience enhanced care and additional services in state-of-the-art facilities with the latest technology and procedures. A comprehensive facilities plan is in development, which will outline the various services offered on each campus.
Q: What does this mean for insurance coverage, and specifically patients with Medi-Cal?
We are closely examining the most common insurance carriers in our region, identifying opportunities, and renegotiating contracts, if necessary.
For Medi-Cal patients, we will maintain the rural health clinic designation in California and these patients will continue to utilize the Barton Community Health Center in South Lake Tahoe for outpatient (non-hospital) services. Patients with Medi-Cal will also have coverage for inpatient services utilized in a Nevada-based hospital.
Most private insurance companies will cover services in both California and Nevada, and we have begun discussion with large carriers to renegotiate contracts to support this change. As Barton currently has facilities in both states and serves a bistate population, structures and processes are in place now to ensure seamless care and coverage.
A small group of insurance plans may not include coverage across state lines; Barton will continue to approach these insurers to identify opportunities, and with outpatient services available on both campuses, this will allow for choice to meet some limited insurance plans.
Q: What will happen to the Skilled Nursing Facility?
Barton values our Skilled Nursing Facility team and the invaluable service provided to our community. As the current Nevada-based hospital approval is directional only, the next year will be spent researching and exercising the plan’s due diligence. Feedback and data-backed variables will determine opportunities for growth and final locations of current services.
Q: Will this affect the Level III Trauma certification?
The American College of Surgeons (ACS) is a national body which certifies Trauma programs. Our Level III Trauma Center is a keystone program, elevating care throughout Barton Memorial Hospital, and remains an integral part of our health system. We will continue to engage ACS and the State of Nevada whenever needed.
Q: What are the regulatory differences between California and Nevada?
Rebuilding the hospital is required. Barton has to assess the best way to accomplish this requirement. Considerations include cost, time, ability to offer comprehensive services, and future growth opportunities.
California is our nation’s most populous state and as a result has a significantly larger volume of requests for regulatory/ oversight/ permitting bodies than Nevada.
Building in Nevada will not compromise the quality and safety standards for building. The standards and requirements for building a safe hospital are federally mandated, and we will follow those guidelines.
California has long and costly waiting lists for permitting and inspection processes that quickly add time and cost to building projects. Nevada has more streamlined processes and the agencies are less impacted, so the process is more efficient which drives the costs down.
Q: What's Ahead?
Throughout the project, Barton has been guided by input from community surveys, stakeholders, partner agencies, and physician and staff teams, along with data from the triennial Community Health Needs Assessment (CHNA), market trends, current health data, state regulations, and CA 2030 seismic requirements for healthcare facilities.
With directional approval from Barton's Board of Directors, the due diligence stage of project planning has commenced including project scope, costs, permitting, timing, and any additional work with regulatory agencies. After which, we will begin planning the specifics of the hospital facility and Nevada campus, as well as, how the California campus will continue to best serve the community's needs.